COMMONWEALTH OF PENNSYLVANIA
BEFORE THE PENNSYLVANIA GAMINGCONTROL BOARD
In the Matter of:
[File, Docket or Other Identifying No.:]
NOTICE OF APPEARANCE
Please enter my appearance in the above designated matter on behalf of.
I am authorized to accept service on behalf of said participant in this matter.
[CHECK ONE]
[] On the basis of this notice, I request a copy of each document hereafter issued by the Board in this matter.
[] I am already receiving or have access to a copy of each document issued by the Board in this matter and do not on the basis of this notice require an additional copy.
_________________________
Signature
_________________________
Attorney Identification Number
_________________________
Name (Printed)
_________________________
P. O. address
_________________________
City, state and zip code
_________________________
Telephone number (including area code)
_________________________
Fax Number (including area code)
_________________________
Email address
58 Pa. Code § 499a.5
This section cited in 58 Pa. Code § 499a.4 (relating to notice of appearance or withdrawal).